A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse prepare the child for next?

Choice A reason: Arrested growth is a common outcome of renal osteodystrophy in children. It is caused by the impaired bone formation and mineralization that result from the abnormal calcium, phosphorus, vitamin D, and parathyroid hormone levels in chronic kidney disease. Arrested growth can lead to short stature, delayed puberty, and poor quality of life.

Choice B reason: Weight gain is not a specific outcome of renal osteodystrophy in children. It may be related to other factors, such as fluid retention, decreased physical activity, or increased appetite due to medications or hormonal imbalances. Weight gain can worsen the kidney function and increase the risk of cardiovascular complications.

Choice C reason: Low blood pressure is not a specific outcome of renal osteodystrophy in children. It may be caused by other factors, such as dehydration, blood loss, infection, or medications. Low blood pressure can affect the perfusion of vital organs and cause dizziness, fainting, or shock.

Choice D reason: Hypervitaminosis D is not a specific outcome of renal osteodystrophy in children. It may occur as a side effect of vitamin D supplementation, which is often prescribed to treat or prevent renal osteodystrophy. Hypervitaminosis D can cause hypercalcemia, which can lead to nausea, vomiting, constipation, confusion, or kidney stones.

Choice A reason: Scheduling the child for a STAT magnetic resonance imaging (MRI) of the neck is not a priority action for the nurse. MRI is a diagnostic test that uses magnetic fields and radio waves to produce images of the internal structures of the body. MRI of the neck may be useful to rule out other causes of respiratory distress, such as tumors, abscesses, or foreign bodies, but it is not an urgent procedure. Moreover, MRI requires the child to lie still for a long time, which may be difficult or impossible for a child who is anxious and in respiratory distress.

Choice B reason: Providing a nebulizer treatment with bronchodilators is not a suitable action for the nurse. Nebulizer is a device that delivers medication in the form of a mist that can be inhaled into the lungs. Bronchodilators are medications that relax the smooth muscles of the airways and improve airflow. Nebulizer treatment with bronchodilators may be helpful for children with respiratory distress caused by asthma, bronchiolitis, or chronic obstructive pulmonary disease, but not for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child.

Choice C reason: Obtaining bedside trays for intubation or tracheotomy by the healthcare provider is the most appropriate action for the nurse. Intubation is a procedure that involves inserting a tube through the mouth or nose into the trachea to secure the airway and provide ventilation. Tracheotomy is a surgical procedure that involves creating an opening in the neck and inserting a tube into the trachea to bypass the upper airway obstruction. Both procedures are life-saving interventions for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child. The nurse should prepare the necessary equipment and assist the healthcare provider in performing these procedures.

Choice D reason: Beginning prescribed intravenous antibiotic administration is not a relevant action for the nurse. Antibiotics are medications that kill or inhibit the growth of bacteria that cause infections. Antibiotics may be indicated for children with respiratory distress caused by bacterial infections, such as pneumonia, tonsillitis, or epiglottitis, but not for children with respiratory distress caused by non-infectious causes, such as foreign bodies, anaphylaxis, or congenital anomalies. Moreover, antibiotics are not an immediate intervention for respiratory distress, as they take time to exert their effects.